MRS. JACQUELYN ALICE BENNETT RN NPI 1083964704

NPI Information

NPI: 1083964704
Provider Name: MRS. JACQUELYN ALICE BENNETT, RN
Classification: Registered Nurse - 163WG0600X
Entity Type: Individual

Specialization: Gerontology

Address:
4540 NE GLISAN ST
PORTLAND, OR
ZIP 97213
Phone: (503) 215-3738
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MRS. Jacquelyn Alice Bennett, RN is a gerontology registered nurse in Portland, OR. MRS. Jacquelyn Alice Bennett, RN NPI is 1083964704. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4540 NE GLISAN ST
PORTLAND, OR
ZIP 97213-333
Phone: (503) 215-3738

The enumeration date for this NPI number is 9/11/2012 and was last updated on 9/11/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WG0600X	Registered Nurse	Gerontology	200340760RN	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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